Individual
BETHANY MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
15477 S PLAZA DR, TAYLOR, MI 48180-5265
(512) 971-8179
Mailing address
15477 S PLAZA DR, TAYLOR, MI 48180-5265
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202009851
MI
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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